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Mitochondrial toxicity of NRTI antiviral drugs: an integrated cellular perspective.

Abstract
Highly active antiretroviral therapy (HAART) regimes based on nucleoside reverse transcriptase inhibitors (NRTIs) have revolutionized the treatment of AIDS in recent years. Although HAART can successfully suppress viral replication in the long term, it is not without significant toxicity, which can seriously compromise treatment effectiveness. A major toxicity that has been recognized for more than a decade is NRTI-related mitochondrial toxicity, which manifests as serious side effects such as hepatic failure and lactic acidosis. However, a lack of understanding of the mechanisms underlying mitochondrial toxicity has hampered efforts to develop novel drugs with better side-effect profiles. This review characterizes the pharmacological mechanisms and pathways that are involved in mitochondrial dysfunction caused by NRTIs, and suggests opportunities for future pharmacological research.
AuthorsWilliam Lewis, Brian J Day, William C Copeland
JournalNature reviews. Drug discovery (Nat Rev Drug Discov) Vol. 2 Issue 10 Pg. 812-22 (Oct 2003) ISSN: 1474-1776 [Print] England
PMID14526384 (Publication Type: Journal Article, Research Support, U.S. Gov't, P.H.S., Review)
Chemical References
  • Reverse Transcriptase Inhibitors
Topics
  • Amino Acid Sequence
  • Antiretroviral Therapy, Highly Active
  • HIV Infections (drug therapy)
  • Humans
  • Mitochondria, Liver (drug effects)
  • Molecular Sequence Data
  • Reverse Transcriptase Inhibitors (pharmacology)
  • Sequence Homology, Amino Acid

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